By Gatonye Gathura
More infant girls than boys are being infected with HIV by their mothers, according to a nine year study carried out in Kenya.
The national study by the Ministry of Health, Kenya Medical Research Institute (Kemri) and the Clinton Health Access Initiative, US, was assessing the status of mother-to-child HIV transmission in the country.
One of its key and surprising finding was that more girls than boys are being infected through this route.
The study published on Tuesday (29th August) had assessed the HIV status of 365,841 Kenyan infants aged below two years from January 2007-July 2015.
For the first in Kenya and in the largest study of its kind the researchers report significant gender imbalance in mother-to-child HIV transmission.
“Overall, we observed slightly higher odds of positivity in female infants compared to male infants from birth to six weeks.”
The study led by Dr Matilu Mwau of Kemri and also involving Dr Martin Siengo, head of the National Aids and STI Control Programme, says the finding is hardly by chance.
“This phenomenon has been described previously and there are theories that female infants may be more susceptible to HIV infection in the womb and soon after birth,” says the study.
The scientists also hypothesize that possibly more of HIV infected male infants die before birth compared to girls hence more infected female live births.
The authors are calling for more confirmatory studies and to better understand this phenomenon.
The other important finding from the study the researchers say is that despite huge efforts and gains in controlling mother-to-child HIV transmission thousands of children are still being infected.
At greatest risk the study says are infants whose infected mothers are not on treatment, babies not on preventive drugs and are on mixed breast feeding.
“Hundreds to thousands of infants are still becoming infected each year because their mothers are not enrolled in care,” says the study.
The researchers, all at top policy making levels say many mothers and infants in Kenya can’t get HIV care for a variety of reasons.
“Barriers to care include distance to health facility and transportation costs, facility inefficiencies, such as stock-outs and long wait times, and persistent shamefulness and stigma.”
The situation the study says is compounded by the fact that many women go to health facilities late in pregnancy if at all with a high proportion delivering outside hospitals.
The scientists also observed cases where infants were infected despite their mothers being on HIV medication.
“Possible reasons for transmission in these infants include late treatment initiation in mothers, non-adherence to treatment, drug failure, drug resistance and stock-outs.
AT A GLANCE
National study of 365,841 under 2-year-olds
Covered nine years from 2007- 2015
11.1 per cent of infants tested HIV positive in 2007-2010 and 6.9 per cent in 2014-2015 more than half girls,
Infants at greatest risk:
Mothers not on HIV medication
Infants not receiving HIV prevention drugs
Mixed breastfed infants